Linking "Big" Geospatial and Health Data: Implications for Research in Environmental Epidemiology.

Schizophrenia is a severe and chronic mental disorder that typically emerges in early adulthood and is characterized by a prolonged disease course, frequent relapse, and substantial functional impairment, resulting in a high disability rate (, ). Epidemiological evidence indicates that approximately 24 million individuals worldwide were living with schizophrenia as of 2019 (), including nearly 8 million in China (). The majority of affected individuals reside in community settings rather than inpatient facilities (). In China, schizophrenia accounted for an estimated 3.67 million disability-adjusted life years (DALYs) in 2017, imposing a substantial burden on both individuals and society (). As a chronic psychiatric illness, schizophrenia affects perception, emotion, cognition, and behavior, leading to impairments in social and occupational functioning (, ). Deficits in cognitive insight—particularly reduced awareness of illness and cognitive distortions—are widely regarded as core features of schizophrenia. Poor cognitive insight is associated with reduced treatment adherence, impaired social functioning, higher relapse rates, and diminished quality of life (, ). Consequently, cognitive insight plays a crucial role in disease progression and rehabilitation outcomes. Family intimacy and adaptability are core dimensions of family functioning (). According to ecological systems theory, effective family functioning significantly influences individual psychological development and mental health (). Prior research suggests that the family environment shapes emotional experiences and cognitive processing, thereby influencing cognitive insight in individuals with schizophrenia (). Wang et al. () reported significant differences in cognitive performance across levels of family functioning, with severe family dysfunction identified as a risk factor for cognitive impairment. However, the specific interaction mechanisms between family functioning and cognitive insight—particularly their dynamic relationships and relative importance as intervention targets—remain insufficiently understood.